Provider Demographics
NPI:1164841698
Name:LOUDOUN MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:LOUDOUN MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SWAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GADDIPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-635-4564
Mailing Address - Street 1:44095 PIPELINE PLZ
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5898
Mailing Address - Country:US
Mailing Address - Phone:703-635-4564
Mailing Address - Fax:
Practice Address - Street 1:44095 PIPELINE PLZ
Practice Address - Street 2:SUITE 410
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5898
Practice Address - Country:US
Practice Address - Phone:703-635-4564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246037207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty